醫師對實證醫學之接受度：全國區域醫院之分析

Adoption of Evidence-Based Medicine: A National Survey of Regional Hospital Physicians

石雅慧(Ya-Hui Shih) ； 羅恆廉(Heng-Lien Lo) ； 翁逸豪(Yi-Hao Weng) ； 丁賢偉(Hsien-Wei Ting) ； 許志成(Chih-Cheng Hsu) ； 陳杰峰(Chieh-Feng Chen) ； 邱亞文(Ya-Wen Chiu) ； 郭耿南(Ken N. Kuo)

《Journal of Medical Education》 14卷3期 (2010/09) Pp. 173-182

https://doi.org/10.6145/jme.201009_14(3).0002

摘要

Purpose: This study aims to identify the relationship between the adoption of evidence-based medicine (EBM) and knowledge of, skill in, barriers against, and attitude toward EBM among regional hospital physicians. Methods: A constructed questionnaire was designed to survey physicians working at 13 randomly selected regional hospitals. Physicians who declared their willingness to apply EBM had grown over the past year were classified into the favorable group (n=251), while those whose willingness to apply EBM had stayed the same or only slightly increased were categorized into the unfavorable group (n=293). A logistic regression model was used to analyze the differences between the two groups. Results: Physicians in the favorable group had a higher positive attitude toward EBM than subjects in the unfavorable group (p＜0.001). The favorable group tended to have a greater understanding of EBM-related technical terms (p＜0.001) and have greater skill in implementing EBM (p＜0.001). In addition, their perceived barriers in applying EBM were significantly lower than among the subjects from the unfavorable group (p＜0.001). The favorable group also accessed the online database more often to search for medical information than the unfavorable group (p＜0.05). After controlling for co-variables, the significant variables were attitude (OR=13.32, p＜0.001) and skills (OR=5.57, p＜0.001). Conclusion: Physicians with a higher perceived improvement in the adoption of EBM have better knowledge of, greater skill in, and a better attitude toward EBM. They also have lower barriers toward applying EBM. The current study suggests that a positive attitude toward EBM and sufficient skills in EBM are the two important factors that enhance the adoption of EBM.

關鍵字

實證醫學 ； 區域醫院 ； 電子資料庫 ； 醫師

並列摘要

Purpose: This study aims to identify the relationship between the adoption of evidence-based medicine (EBM) and knowledge of, skill in, barriers against, and attitude toward EBM among regional hospital physicians. Methods: A constructed questionnaire was designed to survey physicians working at 13 randomly selected regional hospitals. Physicians who declared their willingness to apply EBM had grown over the past year were classified into the favorable group (n=251), while those whose willingness to apply EBM had stayed the same or only slightly increased were categorized into the unfavorable group (n=293). A logistic regression model was used to analyze the differences between the two groups. Results: Physicians in the favorable group had a higher positive attitude toward EBM than subjects in the unfavorable group (p＜0.001). The favorable group tended to have a greater understanding of EBM-related technical terms (p＜0.001) and have greater skill in implementing EBM (p＜0.001). In addition, their perceived barriers in applying EBM were significantly lower than among the subjects from the unfavorable group (p＜0.001). The favorable group also accessed the online database more often to search for medical information than the unfavorable group (p＜0.05). After controlling for co-variables, the significant variables were attitude (OR=13.32, p＜0.001) and skills (OR=5.57, p＜0.001). Conclusion: Physicians with a higher perceived improvement in the adoption of EBM have better knowledge of, greater skill in, and a better attitude toward EBM. They also have lower barriers toward applying EBM. The current study suggests that a positive attitude toward EBM and sufficient skills in EBM are the two important factors that enhance the adoption of EBM.

並列關鍵字

evidence-based medicine ； regional hospitals ； online database ； physicians

參考文獻

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Al-Ansary, L.A.,Khoja, T.A.(2002).The place of evidence-based medicine among primary health care physicians in Riyadh region, Saudi Arabia.Fam Pract.19,537-542.

Al-Omari, F.K.,Al-Asmary, S.M.(2006).Attitude, awareness and practice of evidence based medicine among consultant physicians in Western region of Saudi Arabia.Saudi Med J.27,1887-1893.